The Royal Australasian College of Physicians says doctors should decline gifts and offers of free travel.

It also recommends that in most cases doctors should reject free drug samples.

The college says the guidelines are needed to avoid conflicts of interest and make sure best clinical practice isn’t compromised.

But an independent doctors’ group says the guidelines are only voluntary and don’t go far enough.

Sabra Lane reports.

SABRALANE: The Australian pharmaceutical industry turns over more than $8 billion a year. It spends about $500 million of that on research and development, and significantly more on marketing new drugs.

You’ll often see evidence of it when you visit a GP. It might be a coffee mug or notepad emblazoned with the name of the latest blockbuster drug. They’re designed to foster recognition of a new drug.

Some inducements, though, are quite lavish, but for most patients invisible.

JONJUREIDINI: Well, it ranges from pens and other giveaways that prominently displayed brand names through to becoming consultants for the company, which might involve a meeting that might just need to be attended in Florence, or in New York, or somewhere else like that.

There’s a very great deal of blurring between what’s being offered as a direct gift and an inducement, and what’s being offered as payment for service.

SABRALANE: The Royal Australasian College of Physicians, which represents 9,000 specialist doctors in Australia, today published guidelines on what medicos should accept and reject to avoid conflicts of interest in what they prescribe.

It believes doctors should decline gifts and entertainment.

It says most offers of free drug samples should also be knocked back.

And it believes offers to help cover costs of attending conferences or educational meetings should be carefully considered.

But the guidelines are only voluntary.

College President, Associate Professor Jill Sewell:

JILLSEWELL: We have decided to use guidelines to make people… to help people to take personal responsibility for their choices.

As a college of physicians, we don’t own our members and we can’t necessarily direct them as to what to do.

What we do as a collegial body is to provide very strong guidelines with very good solutions to ethical problems as they come up to people on a day-by-day working basis.

SABRALANE: Healthy Skepticism says the guidelines are good as they go, as in most cases new drugs aren’t a great improvement on cheaper, older alternatives.

But the independent doctors’ organisation says the college should have gone further, by banning pharmaceutical company reps from visiting surgeries.

Jon Jureidini:

JONJUREIDINI: It’s bad for the overall health of a community for doctors to see drug reps, because they tend to get bad information and their prescribing tends to be negatively affected by that. So that’s a step beyond where these guidelines go that we’d like to see doctors take up in the future.

We’d like to see much more money invested in providing independent medical information both for consumers and for doctors.

SABRALANE: But the college believes most doctors are prudent about who they see.

(to Jill Sewell) Do you see pharmaceutical representatives?

JILLSEWELL: I have in the past, and I have always have been very conscious of the need to think very carefully about the sort of evidence that they do present to me, because I know it’s quite likely to be biased in favour of their own products.

I have made… some years ago I made the decision not to see pharmaceutical representatives because I am short of time and I do have better ways to find the exact new evidence.

SABRALANE: The College and Healthy Skepticism agree consumer leaflets found inside drug packaging shouldn’t be left up to the manufacturers.

But Medicines Australia, which represents the drug companies, says they spend millions each year to make sure this information is unbiased. And as the law stands it’s their responsibility and no one else’s to put that information together.

...the condition of freedom in any state is always a widespread and consistent scepticism of the canons upon which power exists.
- Harold J. Laski The Dangers of Obedience. Harpers Monthly Magazine 1-10 June 1929

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